Claim Form Rule: Adding PCS Codes

  • Updated

What claim change is needed?

To add the PCS code to the UB-04 form.  PCS codes are the procedural classification codes, different from the ICD-10 codes, used in inpatient and hospital settings.

Box Number

UB-04: Box 74 - Principal Procedure Code and Date


  1. Navigate to Management Center > Claim Rules
  2. Click "Create Claim Form Rule".
  3. Select the Practice.
  4. Name the claim rule.
  5. Set Claim Type to Institutional depending upon service.
  6. Set conditions for the claim rule to be met.
  7. Select the Available Behavior:  PCD Codes.
  8. Then click Add.
  9. Input the PCS code(s) related to the scenario in question.
  10. At the bottom of the window, click the Create button.

Related Articles

Box 74a-e - Other Procedure Information

To read more about how to set claim rule conditions and order, see the Claim Rule: Setting Claim Rule Conditions article.

To read more about how to set up a claim rule to be effective as of a certain date, see the Scheduled Change Sets article.

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